NPIMap

Organization Active NPI

La Jolla Recovery Inc

Doing business as La Jolla Recovery

  • Substance Abuse Rehabilitation Facility
  • La Jolla, CA
National Provider Identifier
1174187017
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LA JOLLA RECOVERY INC
Doing business as
La Jolla Recovery
Practice address
5978 La Jolla Corona Dr
La Jolla, CA 92037-7447
Phone
(858) 877-3422
NPI assigned
Apr 25, 2019
Last updated
Oct 9, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LA JOLLA RECOVERYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Simons
Title
Ceo
Phone
(858) 877-3422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

5978 La Jolla Corona Dr
La Jolla, CA 92037-7447

Mailing address

1804 Garnet Ave # 233
San Diego, CA 92109-3352
Phone (858) 877-3422

Other names 1

  • La Jolla Recovery Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2191300La Jolla Recovery5978 La Jolla Corona Drive, La Jolla, CA 92037Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory
Tax ID family
La Jolla Recovery Inc3 organizations share this tax ID, including this one
Part of
La Jolla Recovery Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1174187017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE # 233",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352",
            "telephone_number": "858-877-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5978 LA JOLLA CORONA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377447",
            "telephone_number": "858-877-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA RECOVERY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA JOLLA RECOVERY",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-877-3422"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Jolla Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "La Jolla Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.